Obese people could lose some benefits

03 January 2013

Obese people on welfare may be 'encouraged' to exercise or lose some of their benefits, Westminster council has said as local authorities become responsible for wellbeing and health within communities.

At the same time, a report that claimed mildly obese people were no more likely to die prematurely than those who weren't obese has been criticised. And the NHS's obesity services have been described as "extremely patchy".

A report from Westminster council and the Local Government Information Unit (LGIU) said that if GPs suggest such activities as swimming, walking or yoga and people refuse to take part they could lose some of their welfare benefits. Or in the words of the report: "Where an exercise package is prescribed to a resident, housing and council tax benefit payments could be varied to reward or incentivise residents."

Professor John Wass of the Royal College of Physicians (RCP) said: "'Britain is getting bigger and while we try to prevent the increase in obesity, we must also prepare the NHS for the influx of patients presenting with severe complex obesity. A patient may arrive at my hospital with coronary heart disease, but if the root cause of their condition is obesity, we must be equipped to deal with that root cause."

However, he added: "For people to lose weight, they must want to lose weight, and I have concerns about forcing the public to exercise. If we want to solve a problem this big, we need to look at the bigger picture."

Wass said the report in the Journal of the American Medical Association suggesting that being slightly overweight could be good for people flew in the face of most research on the subject.

"Huge pieces of evidence go against this, countless other studies point in the other direction," he said.

The RCP also claimed that there were too many variations in how the NHS dealt with obesity and hospitals and community services needed to work more closely together on the issue.

Prof Lindsey Davies, president of the Faculty of Public Health, said: "The only way we will ever tackle the problems caused by obesity is by everyone working together. Obesity is not only caused by how much we each eat or drink: if tackling it were as simple as telling people to eat less and move more, we would have solved it by now. Our chances of being obese are also affected by factors like whether we have easy access to affordable fruit, veg and other healthy foods, and if it is safe to let our kids play outside."

COMMENTS

I am an asthmatic and have had to take countless drugs, which include steroids. I object to being included in this (group) I have tried all my life to keep slim, but it is a continual battle and one which no matter what I do cannot win. I think a less damming all encompassing statement should be remade and I also think it is time the Public Sector workers in london come and try a slice of life in the countryside!"!! They may then get a real view on what life is like.
E M Savage - Lincolnshire

As a rather large proportionof NHS Employees are purported to be obese why not start an incentivisation with us as a pilot?
Niloc - NHS Kent & Medway

My 'puppy' fat never fell off when I matured as my mum said it would. I tried various diets but didnt stick to any of them. When I got pregnant at 29 I ate for 2 literally but never received any advice on what I needed as opposed to what I wanted. I had only lost 3 of the the extra 5 stones I put on by the time baby number 2 came along. After Atkins diet, and alot of gum disease that accompanied it I tried SlimFast - yuk! I've finally joined Slimming world although some NHS trusts can sign you up to it? Ive had steroid injections for painful joints, back surgery and perhaps with more education - (bearing in mind I have a PhD and I'm not stupid) it could all have been avoided. BMI 29.5 and falling....... You need to help people make the right choices by making it easier. Promote one food labelling system, teach nutrition and exercise better in schools, and ban supersizing.
Dr L - Manchester

Obesity and smoking are epidemic and in general practice I have lost the battle.unable to convince patients to loose weight and stop smoking .I have been trying this for the last 20 years but no success.
Dr.S.C.Hora - Dagenham,Essex

I'm glad to see Professor Wass speaking sense about the importance of motivation to lose weight. Penalising people for not engaging in weight loss activities would be counterproductive, only increasing the stress and financial pressure the individuals are under making engagement in health behaviour even less likely.
We need to put more resources into public health and primary prevention for weight management - for example, we would like to run joint clinics with smoking cessation for young people, as the single biggest barrier to young women giving up smoking is their fear of weight gain - and appropriate, targeted information would help in this area.
Where people are already struggling with weight, we need staged pathways and realistic expectations. Health improvements begin when people achieve 5% weight loss from their initial body weight - and this should be commended, not condemed by the off hand comment "only 5 more stone to go".
Niloc (NHS Kent & Medway) is right, we need incentivisation to work on our own health within the NHS. Again, we can't get funding, even though it is clear that weight contributes to sickness.
Helen Gibbs - Principal Dietitian Cambridgeshire Community Services NHS Trust

Who is making the FSA accountable for what appears in the food chain. They approve chemical after chemical after chemical and wonder why people cant lose weight they are addicted to the chemicals in food. OK easy solution dont buy processed food but people do and they will because its so cheap. Look at every supermarket all the offers are cheap processed foods crisps, biscuits, fizzy drinks etc which cost nothing to make but they make so much profit on them. My town has just approved an application for our 3rd McDonalds but wont let me approch shoppers about a healthy active lifestyle and how i might be able to help them. My biggest gripe though is the Hospitals themselves. I have nurses as clients who cant drink water at their work stations and are too busy to leave the ward to go for a drink - this is absolutely shocking and on top of all this the restaurants and vending machines are absolutely full of processed unhealthy food floor to ceiling rubbish a healthy option is the minority because there is less profit in it. So the hospitals have to lead by example I would love to work with the NHS I have another option for you. I have stopped smoking, completely changed my lifestyle because I have been educated about nutrition I cringe when I see the NHS plate showing you what a plate shoudl look like and on it are pictures of high sugar foods albeit small portions but french fancies please these are just pure sugar they are diabetes in a box and the NHS are advocating this. I have been succesful in my quest due to learning how to control my blood sugar levels and I was a carb and sugar junkie. I have been educated in laymans terms and have never felt better. People wont exercise until they have good nutriiton as this is what gives them natural energy and motivation to want to exercise. So until they ditch the rubbish it's not going to happen. I also educate my clients on the importance of water in temrs of shifting fat. For the ones who dont drink water I set them a challenge drink a glass of water every 2 hours starting with your first one when you get up and then every 2 hours until you have had 8 glasses before they know it they are drinking the water. This could be a great government campaign will messages on radios tube trains, tv social media every hour "Drink a glass of water now, your hair, skin, joints, brain and body will thank you for it" I have just got my own weekly Radio Show on UK Health Radio an dwould love to connect with some of you to try to get the message across. My clients relate to me because I am a normal woman who has struggled with my weight all my life despite being extremely sporty when I was younger, they think well if she gets it I am the same as her I'll get it. They are frightened by Doctors, nurses. So if your looking for new avenues to explore get in touch and we can discuss it further because what's currently in place isn't working
Alison Houghton-Corfield - St. Helens/UK/